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A. Baumritter, The Vision in Preschoolers Study Group; Impact of the Screening Environment on Vision Screening: Results From the Phase II of the Vision in Preschoolers (VIP) Study . Invest. Ophthalmol. Vis. Sci. 2006;47(13):694.
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To describe the environmental conditions encountered when performing vision screening in Head Start Centers, and to assess the impact of these conditions on vision screening.
During Phase II of the VIP Study, screening was conducted at 78 Head Start sites. After formal training and certification, 16 nurse screeners (NS) and 17 lay screeners (LS) completed vision screening on 1541 children between 3 and 5 years of age enrolled in Head Start programs. The battery of tests included: Lea Symbols visual acuity (VA) test, Stereo Smile II test, Retinomax Autorefractor and SureSight Vision Screener. Time in minutes to complete each test was recorded. The characteristics of each screening setting, including adequacy of space, light conditions, level of noise and other environmental distractions were summarized daily by the Project Coordinators using a standardized reporting form. Basic summary statistics, Chi–Square, Fisher’s Exact and Wilcoxon Rank Sum–tests were performed to identify significant differences between administering VIP testing under different environmental conditions.
No significant differences were found between NS and LS with respect to the location, layout and conditions at the screening stations and time required to complete the tests. Most (86%) of the screening was conducted in a gym or other multipurpose room, library, lunchroom, office or classroom, but hallways open to traffic needed to be used in some cases (14%). The screening area was shared with other Head Start activities in 21% of settings. The level of distractions was rated major to severe in 16% of settings. The percentage of children unable to perform the test did not differ by the level of distraction for any of the screening tests. Mean time required to complete testing was greater in settings with no or low distractions vs. major or severe distractions (12.4 min vs. 11.8 min; p= 0.006). Tests requiring more cooperation from the child, Lea Symbols VA (4.2 min vs. 4.0 min; p= 0.02) and Stereo Smile (2.9 min vs. 2.7 min; p= 0.11) did not take longer with distractions, nor did the SureSight (2.6 min vs. 2.4 min; p= 0.13) which uses an auditory signal.
Adverse environmental conditions (pedestrian traffic, noise or other distractions) had no adverse effect on child’s ability to perform vision screening or time required to complete testing. These results suggest that vision screening can be successfully carried out by trained personnel in a "real world" environment where distractions may be present.
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